Ideal time to replace isotonic crystalloid intravenous fluids and sets.

Knowledge Summary Update: This paper is an update to 'Can I Hang? Ideal Time to Replace Isotonic Crystalloid Intravenous Fluids and Sets to Prevent Fluid Contamination and Blood Stream Infection: a Knowledge Summary' by Fausak et al. (2016).Please click the link to view the original paper: https://doi.org/10.18849/ve.v1i4.47. PICO question: In dogs and cats does the changing of IV fluids every 96 hours, compared to longer durations, reduce the risk of contamination in the bag? Clinical bottom line: Category of research: Incidence. Number and type of study designs reviewed: Two prospective studies and a Cochrane systematic review for human patients. Strength of evidence: Weak. Outcomes reported: There was some consistency between the human systematic review and clinical experimental design in the veterinary intensive care unit (ICU). Another experimental study created some heterogeneity in results, where fluids were not contaminated for a long time (60 days), but two factors limit this study's external validity, it was conducted in a clean laboratory environment and ports were wiped with alcohol before culturing samples. Both veterinary studies are limited as they only explored intravenous (IV) fluid bags which had no additives and were not connected to live animals or IV sets. Conclusion: Based on two prospective veterinary experiments and one human Systematic Review (meta-analysis), fluid bags and IV sets should be changed every 72-96 hours. Additionally, supportive evidence suggests that environmental cleanliness and creating a routine of wiping ports with alcohol prior to injection or withdrawal may significantly decrease the likelihood of fluid contamination. This certainly seems to be an area that needs more experimental studies with a low risk of bias on clinical patients.